Usually immunocompetent patients are asymptomatic, but immunosuppressed patients can present with acute pulmonary histoplasmosis, chronic pulmonary infection, and DH.9 DH should be considered in patients with advanced HIV with low CD4 counts who present with nonspecific symptoms, such as unexplained fever and weight loss. This evidence concerns the gene CD4 and dermatitis herpetiformis, familial.